Cape Cod Medical Reserve Corps

The Cape Cod Medical Reserve Corps (CCMRC) became a part of the Barnstable County Department of Health and Environment last year at the request of the Cape and Islands Health Agents Coalition.  Directed by Jean Roma M.S.N., A.P.R.N.-B.C., the CCMRC is fiscally supported through state and federal grant money received by the coalition annually and currently maintains a database of 392 volunteers.  The mission of the CCMRC is to engage volunteers to strengthen public health, emergency response, and build community resiliency. To achieve this mission, CCMRC is committed to building a self-sustaining, trained and credentialed volunteer force.

The biggest challenge of fiscal year 2010 was the declaration of the H1N1 Influenza as national pandemic with state and national protocols reflecting an expanded role for clinical CCMRC volunteers.  As an emergency act declaration, the Public Readiness and Emergency Preparedness Act allowed liability coverage for CCMRC volunteers during the pandemic.  As a result, the CCMRC staffed 57 clinics throughout Cape Cod with over 102 clinical and non-clinical volunteers in 14 out of 15 communities between September 2009 and May 2010.  This resulted in a savings to the towns in excess of $65,000. Additionally, eight volunteers worked with individual health departments answering questions concerning H1N1, booking appointments, and assisting with paperwork prior to clinics.

The second challenge of the CCMRC in fiscal year 2010 was presented as a result of the Recovery and Reinvestment Act, which for a short period of time provided the opportunity to access free vaccines including Shingles, Tetanus and Diphtheria (Td), Tetanus, Diphtheria, and Pertussis (Tdap), Hepatitis A, Hepatitis B, Measles, Mumps, and Rubella (MMR), and Varicella.  Barnstable County Department of Health and Environment worked with the Health Agents Coalition to staff regional clinics in the Upper Cape, Mid-Cape and Lower Cape communities.  The CCMRC Director Jean Roma was the lead nurse for these clinics; facilitating the ordering of vaccines, administrating the vaccines, ensuring proper storage and handling of the vaccines, getting signed MD orders, setting up emergency protocols, and satisfying all of the logistical challenges that present with an off-site clinic.  The five clinic sites were also used as training exercises for Emergency Distribution Sites (EDS).  Lessons learned from our H1N1 distribution were put into action with an increased efficiency in the delivery of vaccines.  Due to the need for booster doses on several of the vaccines, the CCMRC Director will continue to run monthly immunization clinics to facilitate delivery of 2nd or 3rd doses of vaccine through February 2011 to the residents of Cape Cod.  Through this program, 1,104 free doses of vaccine have been administered resulting in a savings in excess of $150,000 in vaccine costs.

The third major initiative undertaken by the CCMRC was the Safe Sun Project which provided sun safety education to a 13-18 year old target population on 14 of Cape Cod’s beaches.  Educational sessions were held from 10am-4pm three days per week for six weeks in July and August of 2010.  The Project was co-sponsored by the Barnstable County Department of Health and Environment and the CCMRC, and also utilized an intern from the Massachusetts Department of Public Health as well as 20 CCMRC volunteers.  Beaches were strategically selected to reach the 13-18 year old target population.  Participants were asked to complete and submit a pre-survey designed to determine the current level of knowledge concerning ultraviolet exposure, which was then followed by a ten minute informational presentation on sun safety. Lastly, a post education survey was completed to measure any increase of knowledge resulting from the intervention.  Over 500 surveys were completed by the target population, with sun safety education being provided for all age groups (approximately 3,000 total participants).  All participants were rewarded with free promotional items including posters, handouts, safe sun tee-shirts, safe sun beach balls, SPF 30 sunscreen, SPF 30 lip balm, and individual packets of SPF sunscreen.

A Department staff member who co-sponsored the Safe Sun Project is currently analyzing data collected in the pre- and post-surveys. This collaborative program is being presented at two upcoming public health conferences in the hopes of sharing information and encouraging the replication of our efforts in other communities.

The fourth initiative of the CCMRC involved preparing and staffing the medical component of Barnstable County’s six regional shelters.  Extensive supplies were ordered and housed in storage containers at each shelter.  In preparation for Hurricane Earl, five shelters were staffed and operated by CCMRC.  Six teams composed of two RN’s, a mental health provider, and a non-clinical team leader were assembled and pre-positioned at each site.  In addition, 20 CCMRC volunteers were deployed to assist the Red Cross with their health care services, with an additional 30 volunteers prepared to provide relief if needed (we recently finalized our memorandum of understanding (MOU) with the Red Cross in order to continue to foster a successful long-term partnership).

The fifth initiative that the CCMRC coordinated was the distribution of 1,500 “Emergency Preparedness Bags”.  Each bag bears the CCMRC logo and a list of items (medications, batteries, first aid kit, etc.) to be stored in the bag for use in emergency situations.  The bags were distributed several days in advance of Hurricane Earl’s arrival to all of the 15 senior centers on Cape Cod, Cape Abilities (a sheltered workshop for the developmentally disabled), Community Connections (a life skills program for the developmentally disabled), the Kennedy Donavan Center (a family support program for the developmentally disabled) and CORD (Cape Organization on the Rights of the Disabled).  The distribution process presented an opportunity to speak with vulnerable populations about emergency preparedness, address fears and answer questions.

Other CCMRC initiatives in the community include seasonal flu clinics, speaker presentations (Tick Borne Diseases, Emergency Preparedness, and Adult Immunizations) and deployment of a pharmacist to the medication collection site in Eastham.  In addition, CCMRC’s Director Jean Roma has conducted several trainings including CPR, renewal CPR, First Aid, Strategies for Dealing with Cognitively Impaired People in a Disaster, Incident Command 100 and Incident Command 700, Emergency Preparedness, and Radio Communication.  During fiscal year 2010 trainings have also been made available to volunteers using the Core Competencies as outlined in the National Medical Reserve Corps Guidelines.